儿童房性心动过速致心动过速性心肌病的相关因素  

Related factors of tachycardia-induced cardiomyopathy caused by atrial tachycardia in children

作　　者：戈海延[1] 李小梅[1] 张宴[1] 刘海菊[1] 李延辉[1] 

机构地区：[1]清华大学医学中心,清华大学第一附属医院心脏中心小儿科,北京100016

出　　处：《中华实用儿科临床杂志》2013年第18期1409-1411,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：清华大学伍舜德博士医学科学研究基金（20240000811）

摘　　要：目的 探讨儿童房性心动过速（简称房速）不同发作类型与心动过速性心肌病的相关性及其高危因素.方法 将72例房速患儿根据左心室射血分数（LVEF）改变分为房速并心动过速性心肌病组及无心肌病组,分析房性心律占全天心搏百分比、心率及房速发作类型与心动过速性心肌病的相关性,比较2组间的差异.结果 72例房速患儿中,心动过速性心肌病发病率为23.6％.无休止性房速患儿心肌病的发病率（53.6％）显著高于短阵房速患儿心肌病发病率（4.5％）（P＜0.01）.心肌病组与无心肌病组相比,房性心律占全天心搏百分比[（98±5）％比（37±4）％]、平均心率[（134.25±19.24）次/min比（100.03 ±18.83）次/min]差异均有统计学意义（P＜0.001,0.05）.心肌病组患儿心动过速控制后,LVEF在6～75 d[（29.44±21.62）d]逐渐恢复正常.结论 房速持续发作,房性心律占全天心搏百分比越高、房速时24 h平均心率越快越易并发心动过速性心肌病；经有效控制房速,心动过速性心肌病可逆转为正常；对存在导致心动过速性心肌病高危因素的房速患儿应早期干预治疗.Objective To investigate the correlation between various types of atrial tachycardia （AT） and tachycardia-induced cardiomyopathy（TIC） in children and to assess the risk factors for the development of TIC.Methods Patients with AT were divided into 2 groups depending on whether complicated with TIC or not,defined as left ventricular ejection fraction（LVEF） ＜ 50％ on echocardiography.The presence of atrial rhythm in Holter monitoring,ventricular rate of AT,and the type of AT onset were compared between the 2 groups; the risk factors associated with TIC were also analyzed.Results Totally 72 patients were enrolled in this study.The incidence of TIC was 23.6％.The incidence of TIC in patients presenting incessant tachycardia was significantly higher than that of patients presenting paroxysmal tachycardia（53.6％ vs 4.5％,P ＜ 0.01）.Patients with TIC had a higher mean atrial rhythm percent [（98 ± 5） ％ vs （37 ± 4） ％,P ＜ 0.001] and faster mean ventricular rate [（134.25 ± 19.24） beats/min vs （100.03 ± 18.83） beats/min,P ＜ 0.05] compared with those without TIC.After successful control of tachycardia,LVEF in patients with TIC gradually recovered within 6 to 75 days [（29.44 ± 21.62） days].Conclusions An incessant AT with higher percent of atrial rhythm and faster mean ventricular rate is more frequently complicated by cardiomyopathy.Recovery of TIC can be achieved after successful control of AT.Early intervention and treatment should be performed for those with high risk factors for the development of TIC.

关 键 词：房性心动过速 心动过速性心肌病 儿童 

分 类 号：R725.4[医药卫生—儿科]